Young people can start to experience anxiety at any point in their childhood, however typically acute anxiety presents around transition times such as school moves, family changes and exams. It is normal to experience some anxiety and trepidation before new experiences.
If young people can be reassured and maintain their function and activity level they do not need a psychiatrist. I see young people who have become so overwhelmed by worry that they start to avoid activities, refuse school or socially isolate themselves. Prompt treatment can avoid disruption to academic progress and reduce distress.
Anxieties are self reinforcing- meaning the longer they are around the more difficult they are to treat. It is a good opportunity to intervene early and build resilience when anxiety is identified in children. ‘OCD’ where worries lead to repetitive behaviours or rituals can also present in children. ‘PANDAS’ – a type of OCD which develops after a period of physical illness should be considered.
Symptoms include:
- School refusal
- Outbursts of intense emotions.
- Challenging behaviours
- Sleep disturbance
- Social withdrawal
- Compulsions and rituals
- Sterotypies or ‘tics’
A holistic assessment exploring ‘why’ not just ‘what’ is essential.
Treatment can include:
- CBT (first line treatment for all young people with anxiety disorders)
- Medication
- School liaison including advice regarding adjustments and timetables.
- Family therapy (anxiety is often shared by other family members)